Yes, the UE/LE split came from the medical industry as a way to maximize 
profits.  I am not sure why the OT and PT professions did not see this and do 
something about it.

David A. Lehman, PhD, PT
Associate Professor
Tennessee State University
Department of Physical Therapy
3500 John A. Merritt Blvd.
Nashville, TN 37209
615-963-5946
[EMAIL PROTECTED]
Visit my website:  http://www.tnstate.edu/interior.asp?mid=2410&ptid=1


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________________________________________
From: [EMAIL PROTECTED] [EMAIL PROTECTED] On Behalf Of Ron Carson [EMAIL 
PROTECTED]
Sent: Saturday, October 18, 2008 6:53 PM
To: Bill Maloney
Subject: Re: [OTlist] OTlist Digest, Vol 43, Issue 17

Bill,  I  am  still digesting your message, but I want to make a quick
comment.

Earlier,  someone  asked  how  OT became cornered into UE treatment. I
don't  KNOW  the  answer but now I'm wondering if productivity demands
aren't part of the reason.

Any opinions out there?

Ron

----- Original Message -----
From: Bill Maloney <[EMAIL PROTECTED]>
Sent: Saturday, October 18, 2008
To:   [email protected] <[email protected]>
Subj: [OTlist] OTlist Digest, Vol 43, Issue 17

BM> OK, time for me to chime in.  Been reading long enough, and felt the need to
BM> offer some thoughts, hopefully insightful and helpful but more than anything
BM> else just an "amen", to this thread.

BM> The productivity "problem" isn't unique to HH, or any other profit-driven
BM> setting.  And, let's not kid ourselves here people....we hear all the fancy
BM> mission statements and "recruiter speak" from any/all organizations; and,
BM> while they sound good, at the end of the day the ONLY mission that matters
BM> is PROFIT.  Like it or not, agree or not, that is the FACT.  It's no wonder
BM> that those clinicians (of whichever discipline) who support that mission are
BM> the stars.  So, there obviously is no solution to this situation.

BM> I've been fortunate enough over the years to dodge disciplinary action due
BM> to low productivity (which is almost a forgone conclusion if you focus on
BM> quality of care, or if the employer has low OT census).  And, for what it's
BM> worth Ron, my current HH employers productivity standard for OT is 32
BM> points/week (OT initial evaluation counts as 1.5 points and subsequent
BM> visits are weighted as 1).  I have, for the past year and a half of
BM> employment, consistently run around 20 to 25 points.  Of course, many of my
BM> PT colleagues run higher than that for the same reason you mentioned, they
BM> do 10 to 15 minute visits (yes, this is verified and factual).  I have
BM> personally witnessed nurses do 5-minute visits.  BUT, I literally cannot
BM> tell you how many patients say, unsolicited, to me things like, "I get so
BM> much more out of your visits than that other guy/gal."  Duh!  Of course they
BM> do!!!  I am actually taking the time to listen, intervene, teach, treat,
BM> care...provide a valuable and obviously relevant (to them) service.  This
BM> gets back to my employers, via various avenues, and I guess the positive PR
BM> in some ways outweighs the productivity deficit.  I can relate to what you
BM> said, Ron, when you leave a patients home sweating and exhausted from your
BM> beautiful efforts, and the only feedback you get from the boss is that your
BM> productivity is low.  All the while, the clinicians who exceed the quota,
BM> yet SUCK clinically and ethically, get the praise!  It's honestly so
BM> disgusting at times, I wonder why I/we bother.  But then I remember that
BM> little man/woman who looks me right in the eye and tells me, in their own
BM> words how much they appreciate what I do.  That may not immediately impact
BM> others' knowledge of "what OT is" but I truly believe it's a start.  I know
BM> that doesn't "solve" our plight, but isn't that why we do what we do
BM> anyway?  At some point, I/we have to believe that we'll impact a difference
BM> in this grass-roots way.

BM> There is a new OT publication beginning circulation, "Today in OT" (GHG
BM> Gannett Healthcare Group, a subsidiary of Gannett Company, Inc. [USA Today])
BM> which ended up in  my mailbox this week.  I also get "Advance for
BM> Occupational Therapy Practitioners" but not sure how these find me since I
BM> am not a current member of AOTA, or the Texas OT Assn. (a story for another
BM> time I suppose).  I am not a literature snob, but know that these are not
BM> the benchmark references for evidence-based practice.  But some of the
BM> articles are interesting, informative and thought-provoking nonetheless.
BM> Interestingly enough, one article in particular in "Today in OT" entitled
BM> "Improving Your Ability to Think Critically" was written by an RN who was
BM> highlighting OTs in particular for this being a leader in this skill.  Also,
BM> the cover article was entitled, "By Leaps and Bounds - OT gains momentum as
BM> one of the best professions."   I have to believe that at some point OT will
BM> evolve into what we all want and so richly have earned through our daily,
BM> grass-roots struggles.

BM> While I acknowledge my posting has not solved or resolved anything, I hope
BM> that I have placed at least a small amount of "hoorah" in your day.  Hang in
BM> there.  By the read of these postings, our profession is in good hands.  I
BM> believe there are enough of us out here who practice sound, evidence-based
BM> and relevant Occupational Therapy to advance our profession.  I enjoy
BM> reading these posts, so keep 'em coming.

BM> Bill Maloney, OTR
BM> Dallas, Texas





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